Trends in the Use of Second-Generation Androgen Receptor Axis Inhibitors for Metastatic Hormone-Sensitive Prostate Cancer and Clinical Factors Predicting Biological Recurrence
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Statistical Analysis
3. Results
3.1. Trends in ARAT Agent Use
3.2. Comparison of Progression-Free Survival according to ARAT
3.3. Uni- and Multivariate Analyses for Factors Predicting BCR
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | All | Abiraterone | Apalutamide | Enzalutamide | p-Value |
---|---|---|---|---|---|
Number of patients | 276 | 163 | 70 | 43 | |
Age (years, median, IQR) | 73.0 (68.0–79.0) | 73.0 (68.0–79.0) | 73.5 (69.0–78.7) | 73.0 (65.5–76.0) | 0.575 |
ECOG-PS (number, %) | 0.792 | ||||
0 | 198 (71.7) | 117 (71.8) | 51 (72.9) | 30 (69.8) | |
1 | 46 (16.7) | 24 (14.7) | 13 (18.6) | 9 (20.9) | |
2 | 27 (9.8) | 19 (11.7) | 5 (7.1) | 3 (7.0) | |
3 | 3 (1.1) | 2 (1.2) | 0 (0.0) | 1 (2.3) | |
4 | 2 (0.7) | 1 (0.6) | 1 (1.4) | 0 (0.0) | |
Initial PSA (ng/mL, median, IQR) | 286.5 (68.7–1163.2) | 409.0 (78.8–1656.0) | 185.9 (57.5–598.3) | 380.4 (92.5–1011.9) | 0.05 |
Gleason score (number, %) | 0.002 | ||||
≤6 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
7 | 12 (4.3) | 1 (0.6) | 8 (11.6) | 3 (7.0) | |
≥8 | 262 (95.0) | 161 (99.4) | 61 (88.4) | 40 (93.0) | |
Clinical T stage (number, %) | 0.927 | ||||
1c | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
2 | 42 (15.2) | 24 (14.7) | 11 (15.7) | 7 (16.3) | |
3 | 134 (48.6) | 81 (49.6) | 35 (50.0) | 18 (41.9) | |
4 | 92 (33.3) | 55 (33.7) | 21 (30.0) | 16 (37.2) | |
x | 8 (2.8) | 3 (1.8) | 3 (4.3) | 2 (4.7) | |
Lymph node involvement (number, %) | 0.461 | ||||
Negative | 111 (40.2) | 62 (38.0) | 30 (42.9) | 19 (44.2) | |
positive | 165 (59.8) | 101 (62.0) | 40 (57.1) | 24 (55.8) | |
Number of bone metastasis (number, %) | <0.001 | ||||
1 | 18 (6.5) | 5 (3.1) | 11 (16.2) | 2 (5.0) | |
2 | 11 (3.9) | 2 (1.2) | 7 (10.3) | 2 (5.0) | |
≥3 | 225 (81.5) | 144 (88.9) | 45 (66.2) | 36 (90.0) | |
Visceral metastasis (number, %) | 93 (33.7) | 59 (36.2) | 23 (32.9) | 11 (25.6) | 0.418 |
Patients who met the criteria for high-risk PCa in the LATITTUDE trial (number, %) | 245 (89.2) | 160 (98.2) | 50 (71.4) | 35 (81.4) | <0.001 |
WBC (count/μL, median, IQR) | 6680 (5500–7860) | 6600 (5470–7810) | 6690 (5500–8280) | 6800 (5800–7800) | 0.668 |
Neutrophil (count/μL, median, IQR) | 4100 (3235–5311) | 4100 (3200–5140) | 4200 (3235–5444) | 4000 (3373–5587) | 0.816 |
Lymphocyte (count/μL, median, IQR) | 1500 (1191–1892) | 1500 (1200–1803) | 1400 (1096–1911) | 1440 (1247–2229) | 0.584 |
NLR | 2.74 (2.00– 3.90) | 2.73 (2.00–3.82) | 2.77 (1.76–4.49) | 2.54 (1.92–3.38) | 0.860 |
ALP (U/L, median, IQR) | 275 (174– 605) | 401 (235–923) | 213 (101–310) | 158 (102–299) | <0.001 |
LDH (U/L, median, IQR) | 204 (178– 243) | 205 (178–248) | 198 (169–229) | 206 (182–242) | 0.397 |
Albumin (g/dL, median, IQR) | 4.0 (3.6– 4.3) | 3.9 (3.5–4.2) | 4.1 (3.7–4.3) | 4.0 (3.8–4.3) | 0.099 |
CRP (mg/dL, median, IQR) | 0.23 (0.06–1.06) | 0.26 (0.08–1.27) | 0.20 (0.04–1.15) | 0.19 (0.06–0.81) | 0.487 |
Follow-up period(months, median, IQR) | 12.0 (6.0–22.5) | 19.0 (8.5–27.0) | 9.0 (7.0–12.0) | 7.0 (4.5–12.5) | <0.001 |
Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|
HR | 95% CI | p-Value | HR | 95% CI | p-Value | |
Age (≥73 vs. <73 years) | 3.040 | 0.847–10.900 | 0.087 | - | - | - |
ECOG-PS (≥1 vs. 0) | 2.140 | 0.741–6.176 | 0.159 | - | - | - |
Albumin (≥3.8 vs. <3.8 g/dL) | 0.351 | 0.120–1.077 | 0.068 | - | - | - |
NLR (≥2.76 vs. <2.76) | 11.690 | 1.495–91.480 | 0.019 | 9.700 | 1.2010–78.360 | 0.033 |
Hemoglobin (≥13.1 vs. <13.1 g/dL) | 0.450 | 0.150–1.344 | 0.153 | - | - | - |
Gleason score 5 (yes vs. no) | 1.473 | 0.461–4.703 | 0.513 | - | - | - |
Initial PSA (≥413 vs. <413 ng/mL) | 0.745 | 0.249–2.226 | 0.599 | - | - | - |
Time to PSA nadir (≥ 6 vs. <6 months) | 0.161 | 0.042–0.602 | 0.007 | - | - | - |
PSA level 3 months after the start of first-line treatment (≥0.55 vs. <0.55 ng/mL) | 7.191 | 1.608–32.170 | <0.001 | 10.840 | 1.3620–86.360 | 0.024 |
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Nakane, K.; Watanabe, H.; Naiki, T.; Takahara, K.; Yasui, T.; Miyake, H.; Shiroki, R.; Koie, T. Trends in the Use of Second-Generation Androgen Receptor Axis Inhibitors for Metastatic Hormone-Sensitive Prostate Cancer and Clinical Factors Predicting Biological Recurrence. Diagnostics 2023, 13, 1661. https://doi.org/10.3390/diagnostics13091661
Nakane K, Watanabe H, Naiki T, Takahara K, Yasui T, Miyake H, Shiroki R, Koie T. Trends in the Use of Second-Generation Androgen Receptor Axis Inhibitors for Metastatic Hormone-Sensitive Prostate Cancer and Clinical Factors Predicting Biological Recurrence. Diagnostics. 2023; 13(9):1661. https://doi.org/10.3390/diagnostics13091661
Chicago/Turabian StyleNakane, Keita, Hiromitsu Watanabe, Taku Naiki, Kiyoshi Takahara, Takahiro Yasui, Hideaki Miyake, Ryoichi Shiroki, and Takuya Koie. 2023. "Trends in the Use of Second-Generation Androgen Receptor Axis Inhibitors for Metastatic Hormone-Sensitive Prostate Cancer and Clinical Factors Predicting Biological Recurrence" Diagnostics 13, no. 9: 1661. https://doi.org/10.3390/diagnostics13091661